Provider Demographics
NPI:1225601701
Name:RIVERA-PABON, YANELIS ESTER (MD)
Entity Type:Individual
Prefix:
First Name:YANELIS
Middle Name:ESTER
Last Name:RIVERA-PABON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CALLE PADIAL STE 340
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3807
Mailing Address - Country:US
Mailing Address - Phone:787-337-5020
Mailing Address - Fax:
Practice Address - Street 1:30 CALLE PADIAL STE 340
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3807
Practice Address - Country:US
Practice Address - Phone:787-337-5020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22433208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice